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Traumatic glaucoma
Glaucoma
Key Points
- •Angle recession glaucoma is the most important late-onset mechanism of traumatic glaucoma - caused by tearing of the ciliary body between longitudinal and circular muscle fibers; recession >180 degrees carries ~6% risk of glaucoma over 10 years (Kaufman & Tolpin)
- •Ghost cell glaucoma presents 1–3 months after vitreous hemorrhage with khaki/tan-colored rigid cells in the AC; diagnosed by 1% methyl violet stain of AC aspirate; treated by AC washout ± vitrectomy
- •Gonioscopy is the CRITICAL investigation - compare BOTH eyes for widened ciliary body band, torn iris processes, and irregular TM pigmentation; angle recession may be the only sign of prior trauma
- •Laser trabeculoplasty (SLT/ALT) is generally ineffective in angle recession glaucoma because the damaged TM does not respond; prostaglandin analogues are first-line medical therapy
- •Traumatic glaucoma can present decades after the original injury - all patients with angle recession >180 degrees require lifelong annual IOP monitoring
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Keep reading Traumatic glaucoma
17 more sections are included with the Clinical plan.
- Definition
- Epidemiology
- Aetiology and causes
- Pathogenesis
- Classification
- Risk factors and associations